Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions.

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Abstract

[Indexed for MEDLINE] 4. Best Pract Res Clin Endocrinol Metab. 2011 Aug;25(4):585-91. doi: 10.1016/j.beem.2011.05.002. The effect of vitamin D on bone and osteoporosis. Lips P(1), van Schoor NM. Author information: (1)Endocrine Section, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands. p.lips@vumc.nl The main effect of the active vitamin D metabolite 1,25(OH)2D is to stimulate the absorption of calcium from the gut. The consequences of vitamin D deficiency are secondary hyperparathyroidism and bone loss, leading to osteoporosis and fractures, mineralization defects, which may lead to osteomalacia in the long term, and muscle weakness, causing falls and fractures. Vitamin D status is related to bone mineral density and bone turnover. Vitamin D supplementation may decrease bone turnover and increase bone mineral density. Several randomized placebo-controlled trials with vitamin D and calcium showed a significant decrease in fracture incidence. However, very high doses of vitamin D once per year may have adverse effects. When patients with osteoporosis are treated with a bisphosphonate, they should receive a vitamin D and calcium supplement unless the patient is vitamin D replete. These subjects are discussed in detail in this review. Finally, the knowledge gaps and research agenda are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.beem.2011.05.002